‘Waste' cited in health spending

Health care compared to getting to moon.

By Robert Pear, New York Times

Published 10:25 pm, Saturday, December 3, 2011

WASHINGTON — The official in charge of Medicare and Medicaid for the last 17 months says 20 to 30 percent of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.

The official, Dr. Donald Berwick, listed five reasons for what he called the “extremely high level of waste”: overtreatment of patients, the failure to coordinate care, the administrative complexity of the health care system, burdensome rules and fraud.

In an interview Thursday, his last day on the job, Berwick reflected on his successes, failures and frustrations in trying to engineer a rapid transformation of the health care.

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President Barack Obama nominated Berwick to be the administrator of the Centers for Medicare and Medicaid Services in April 2010. While the Senate was investigating Berwick's qualifications, Obama circumvented Congress by giving him a temporary recess appointment, a shortcut that infuriated Republicans and irked some Democrats. The appointment was due to expire at the end of this year.

“I came with an agenda,” Berwick said. “I wanted to try to change the agency to be a force for improvement, covering one out of three Americans.”

Asked why Americans were still deeply divided over the new health care law, signed 20 months ago, Berwick said: “It's a complex, complicated law. To explain it takes a while. To understand it takes an investment that I'm not sure the man or woman in the street wants to make or ought to make.”

But, Berwick said, just as Americans supported manned missions to the moon without knowing the details of rocket science, they ought to support the new law because of its ultimate destination.